Osteoarthritis (OA) is the most common form of arthritis, afflicting about 27 million Americans of all ages. It rarely begins before the age of forty, but an estimated 40 to 80 percent of people over the age of sixty-five have some degree of arthritis. The majority of arthritis sufferers do not seek medical treatment. For some people with arthritis, the symptoms remain mild, while in others (about 16 million) symptoms grow progressively worse until they become disabling. Approximately 15 percent of my patients are suffering with osteoarthritis. The most common joints affected by OA are the weight-bearing joints: the knees, hips, and spine. However, there are many people who begin with pain in their thumb and fingers.
Osteoarthritis is an inflammation of the joints that causes a breakdown in the cartilage covering the bone inside the joint. Arthritis usually involves a synovial joint—one that is encased in a tough fibrous capsule lined with a membrane that secretes a thick, clear synovial fluid. This type of joint connects one bone to another and, with the fluid lubricating the cartilaginous surfaces, allows for smooth motion. The cartilage covering the ends of the bones is made of a soft cushion-like material that acts as a shock absorber and prevents the bones from rubbing against each other.
Arthritis is a progressive degeneration of the cartilage resulting from the wear and tear on the joint combined with the body’s inability to regenerate the cartilage at the same pace. In an arthritic joint there may either be insufficient synovial fluid, causing stiffness, or an excess, causing swelling. If the cartilage has broken down enough to allow the bones to rub against each other, there is significant pain. The body often attempts to repair the joint damage by producing bony outgrowths at the margins of the affected joints. These spurs can also cause pain and stiffness.
The primary symptoms of arthritis are:
• Intermittent pain with motion of affected joints
• Stiffness and limitation of movement, with audible cracking in the joints
• Swelling and deformity of the joint
• Pattern of gradual onset
There are two types of osteoarthritis:
1. Primary—results from normal wear and tear
2. Secondary—results from an injury to a joint; from disease; or chronic trauma, such as obesity, postural problems, or occupational overuse
Since osteoarthritis is an inflammatory condition, the following recommendations are very similar to those in Chapter 5, with the exception of topicals for localized joint pain. These creams, sprays, and lotions can be highly effective for relieving pain without getting high, and are ideal for use while working during the day.
• Juicing raw cannabis leaves—for those without access to fresh plants, THCa tincture, CBDa tincture, and CBD tincture are excellent alternatives
• Topicals—localized (apply to painful joints): Apothecanna Extra Strength, Mary’s Medicinals CBC
• Topicals—generalized (apply to wrist or ankle for rapid absorption) transdermal patches, especially 3:2/CBDa:THCa; THCa; 1:1/CBD:THC.
• Vaporize high-CBD strains of flower: Harlequin (a 50:50 hybrid), Lucy (a 70:30/I:S indica), Cannatonic (a 50:50 hybrid); other hybrids (either 50:50, 60:40/S:I or 60:40/I:S); or other high-CBD strains
• High-CBD tinctures: 1:1, 2:1, 3:1, 6:1, or 20:1/CBD:THC
• High-CBD hash oil: 3:1, 6:1, or 20:1/CBD:THC, either vaporized or ingested
• Indica strains of flower, with I:S of 70:30 or above
• Indica and hybrid edibles—gluten-free, without sugar or dairy
• Any strain or MMJ product containing CBG
NOTE: Use caution with sativa strains above 60:40/S:I and high-THC products. Although THC has anti-inflammatory properties and can be useful to some patients, it can also increase anxiety, which has the potential to increase inflammation.
The most important time to start a holistic medical treatment plan is right at the onset of symptoms. If you start feeling abnormally stiff in the mornings, and are having some soreness in one or more joints, possibly accompanied by intermittent swelling, this is the critical time to start treating! If you act quickly you can prevent the joints from degenerating by reducing inflammation and saving the cartilage.
I’ve often seen patients who chose to live with the symptoms for many months or years and then suddenly their joints begin rapidly deteriorating. Pain becomes more severe, they’re increasingly dependent on pain medication, mobility is more restricted, and they have joint replacement recommended by an orthopedist.
The HMTP Program can prevent this scenario. Even if you have been living with OA for several years, it’s still possible to greatly improve and minimize further damage to your joints.
The three most important steps for preventing joints from degenerating and possibly reversing the early stages of damage are:
1. Reduce inflammation: Put a hose on the fire through the HMTP outlined below. This helps minimize damage to cartilage.
2. Feed cartilage: Cartilage does not have a direct blood supply, so you need to provide it with nutrients that are easily absorbed. This helps the cartilage repair, while keeping the synovial membranes healthy and the joints well lubricated.
3. Exercise: Keep the joint capsules healthy by proper exercise and conditioning. You want to exercise in a way that will not contribute to more joint wear and tear, so avoid any impact exercise, especially running or jumping. You might benefit from the guidance of a personal trainer or a physical therapist.
• Genetic predisposition
• Severe or recurrent joint injury from heavy physical activity
• Skeletal postural defects and congenital joint instability
• Excess weight—excessive body weight and high body mass index are significant predictors of osteoarthritis of the knee. The risk for arthritis of the knee is 50 to 350 percent greater in men who are the heaviest compared to those of normal weight. This principle probably relates to other weight-bearing joints as well.
• Exercise—there is some evidence that only the most violent joint-pounding activities (long-distance running, basketball, etc.) performed over many years will predispose you to the development of arthritis.
• Cold climate and barometric pressure changes
• Food allergy, especially allergy to nightshades (potatoes, tomatoes, peppers, and eggplant), wheat/gluten, and dairy
• A diet high in animal products
• Low-grade infections, such as dental infections or infections in the gut that make the intestines “leaky,” therefore adding to general toxic load and inflammation.
• Dehydration
• Excessive acid in the body causing increased amounts of calcium, minerals, and acid toxins to be deposited in the joint, resulting in inflammation and pain.
• Gut dysbiosis and leaky gut syndrome—recent research has shown that disordered gut bacteria (dysbiosis) may be creating toxins that increase inflammation throughout the body, in addition to leaky gut syndrome. This is a condition in which the gut lining becomes thin and damaged and begins to abnormally absorb toxins and incompletely digested food, which in turn, triggers joint inflammation. A holistic doctor can check for these problems with stool and blood testing and design an effective plan for reversing this causative factor.
Arthritis, like any other chronic condition, is a systemic (whole body) dis-ease. It is not usually just a local dysfunction of a particular joint. If there is no major joint degeneration (i.e., you have no cartilage left—bone on bone), it is curable using a holistic whole-body approach.
The first step in treating arthritis is to remove all inflammatory causes. Many people with arthritis have food allergies that cause joint inflammation. Dairy products; wheat- and gluten-containing grains like rye, barley, and spelt; and (due to the acid they contain, called solanine) nightshade plants, which include potatoes, peppers, eggplant, tomatoes, and tobacco, are most often responsible for these food allergies. Eliminating all of them from your diet for at least one month (preferably for three months) will help to determine if a food allergy is contributing to your arthritis. You can then gradually reintroduce them (one food every three to four days) and carefully record, using the 0 to 10 pain scale, if you have a flare-up of joint pain. There is also now sophisticated food sensitivity blood testing that your holistic doctor can do to determine which foods you react to, and it can test up to 180 foods at a time.
The next step is to remove or decrease consumption of all animal products other than fish, which will help to eliminate excess calcium, mineral deposits, and acid from the joints. The most effective way to do this is to eat a raw food vegetarian diet. This is also called a vegan diet (vegetarian plus elimination of all animal products, especially dairy).
Even if you do this for only one to two months, there is an excellent chance that you will feel significantly better. If this is too extreme for you, then allow organic, chemical-free animal foods on a more limited basis, with a portion the size of the palm of your hand once or twice daily. Fresh wild-caught ocean fish, as well as eggs, chicken, turkey, and lamb are best if you are including animal protein. If you do nothing else, then strictly avoid dairy and red meat products.
The most effective way to dramatically reduce inflammation, increase joint comfort, and lessen stiffness is to do a supervised medical-grade detoxification program. There are a number of seven-, ten-, and twenty-eight-day professional programs based on good clinical and scientific research for rapidly reducing pain and inflammation.
Todd Nelson, a naturopathic doctor with whom I’ve worked closely for nearly thirty years (and a contributing author to this chapter), has guided several thousand people through these programs with exceptional results. Detoxification programs typically use Functional Medicine (a form of alternative medicine that focuses on interactions between the environment and the gastrointestinal, endocrine, and immune systems)–based food drinks along with low-allergy foods. If you are interested in these programs, Todd’s contact information is available in Resources. He frequently guides patients long-distance via phone and Skype.
A more intensive approach to cleansing is periodic supervised fasting, which also has a very high success rate. This is not a new idea. For more than fifty years, fasting clinics throughout Europe have had outstanding results with periodic juice fasting. Gabriel Cousens, MD, at his Tree of Life Rejuvenation Center in Patagonia, Arizona, has administered to a number of people a juice fasting program for treating arthritis and has been consistently successful. Fasting enhances the eliminative and cleansing capacity of the lungs, skin, liver, and kidneys. It also rests and restores the digestive system and helps to relax the nervous system and mind. If you’re considering fasting as a therapeutic option, it is best to do it under the supervision of a well-trained physician.
Refer to the anti-inflammatory diet in Chapter 5 for more specifics on reducing inflammation. Diet is a critical factor in slowing, or even stopping, the arthritic inflammation. There is no way to heal your joints without significant dietary changes.
Weight reduction, through diet and exercise, is also recommended in treating arthritis, as excess weight can accelerate joint deterioration.
The following are professional dietary supplement recommendations we (Dr. Nelson and I) use in our clinics every day with great success. There are many supplements claiming to improve joint health and reduce inflammation, but the majority are not scientifically supported, have minimal quality control, and simply don’t work. Each product suggested below is reinforced with substantial science and clinical data, along with the most stringent standards of quality control in the industry.
Wellness Essentials Active packets are formulated to feed cartilage, help your body to naturally reduce inflammation without the harsh side effects of anti-inflammatory medications, and promote general health. The result is improved joint flexibility, mobility, and comfort. This product is from Metagenics—see Resources.
• Multifaceted health support: PhytoMulti is a high-quality multivitamin, containing essential nutrients and a proprietary blend of concentrated extracts and phytonutrients to help protect cells, maintain DNA stability, and activate health potential.
• Pain relief: Kaprex provides a safe option for effective joint pain relief, with a proprietary combination of selected plant components, particularly from hops.
• Joint health support: ChondroCare is a comprehensive formula designed to provide broad connective tissue support, with glucosamine, chondroitin, methylsulfonylmethane (MSM), and other nutrients.
• Healthy cartilage support: Glucosamine Sulfate 750 helps support healthy joints and other connective tissues by providing additional glucosamine, a naturally occurring compound in all connective tissues.
• Anti-inflammation support: OmegaGenics EPA-DHA 500 is a quality-guaranteed omega-3 fatty acid formula providing third party–tested omega-3 fatty acids to ensure greater purity.
Recommended dosage: Take one packet daily with food.
The primary nutrients included in the Wellness Essentials Active packets that are most effective for treating OA are the following:
• Glucosamine sulfate: Glucosamine is a naturally occurring chemical found in the human body, primarily in the fluid around joints. It can also be made in the laboratory and found in other places in nature. For example, the glucosamine sulfate that is put into dietary supplements is often harvested from the shells of shellfish. Glucosamine is a building block of cartilage and can be used to repair damaged or to grow new cartilage. Although it is not an anti-inflammatory, a multitude of studies (more than three hundred, including twenty double-blind studies) have shown that glucosamine can relieve the pain of osteoarthritis. This supplement is considered safe, but it can occasionally produce heartburn and diarrhea. It usually takes four to eight weeks to get significant benefit from glucosamine. If you are allergic to shellfish, you should not take this.
• Chondroitin sulfate: Chondroitin is a major component of cartilage that helps it retain water. It’s extremely important to get high-quality, toxin-free chondroitin, which Wellness Essentials Active packets contain. Chondroitin taken with blood-thinning medications like NSAIDs may increase the risk of bleeding. If you are allergic to sulfonamides, start with a low dose of chondroitin sulfate and watch for any side effects. Other possible side effects include diarrhea, constipation, and abdominal pain.
• Essential fatty acids: There are many studies demonstrating the benefits of omega-3 oils from cold-water fish (salmon, sardines, and tuna) for people with OA. It’s important to have extremely pure forms of fish oils that are not contaminated with heavy metals, cholesterol, or other toxins. Organic flaxseed oil has also been shown to reduce arthritic inflammation. Take one to two tablespoons daily.
• MSM: MSM (methylsulfonylmethane) is frequently recommended for OA. There are many anecdotal reports of its benefit in treating the problem, but very little controlled data. MSM is hypothesized to deliver sulfur to arthritic joints, and thus act as an anti-inflammatory and pain reliever. MSM may also have a blood thinning effect. Be aware that MSM is not chemically related to sulfa drugs, and thus is not contra-indicated with sulfa allergy.
• Kaprex: hops extract. Metagenics is the only supplement company offering a joint health formula that is based on a patented hops extract that has been extensively researched for increasing joint comfort.
• OmegaGenics SPM Active (Metagenics): a fish-oil derivative that Harvard studies demonstrate accelerates the resolution of inflammation. Begin with a loading dose of two capsules three times a day with food for one to two weeks, followed by a maintenance dose of one to four capsules a day.
• Vitamin D3. See the recommendations for vitamin D in Chapter 5.
• Niacinamide is a B vitamin (B3), similar to niacin, which has been beneficial in treating arthritis. The recommended dosage is 500 mg three to four times daily, but some people will benefit with as little as 250 mg three times daily. The only reported negative side effect is that on rare occasions it can be harmful to the liver. A periodic liver profile (blood test) can monitor your liver function. Available in health food stores.
• S-adenosyl methionine (SAM-e) has been successful for treating arthritis for more than thirty years in Europe. You can try 400 mg one to two times daily. Found in health food stores.
Yoga can be especially beneficial as part of the treatment program for arthritis. Whatever form of exercise you choose, it should not cause direct pounding or contribute to the deterioration of the affected joints. Swimming is a good choice for arthritis sufferers.
Traditional Chinese medicine, both acupuncture and Chinese herbs; Ayurvedic medicine, especially Boswellin Cream, camphor, and eucalyptus oil; bodywork (Rolfing and Hellerwork); body movement therapies, such as Feldenkrais, Trager, and Pilates (can improve mobility of the affected joints); chiropractic and osteopathic manipulation (can increase circulation to the joint); homeopathy; and craniosacral therapy can all be helpful in treating arthritis.
Louise Hay, in You Can Heal Your Life, lists as a probable emotional cause of arthritis: “Feeling unloved. Criticism, resentment.” The affirmation that she recommends is: I am love. I now choose to love and approve of myself. I see others with love.
Caroline Myss, in Anatomy of the Spirit, writes that she believes the mental/emotional issues related to arthritis are:
• Sensitivity to criticism—probably the most significant emotional factor
• Trust
• Fear and intimidation
• Self-esteem, self-confidence, and self-respect
• Care of oneself and others
• Responsibility for making decisions
• Personal honor
There are a number of affirmations that you could create, directly related to the joints affected by arthritis or to the activity the arthritis prevents you from doing. For example: “My fingers move freely and easily.” “My hands are filled with energy and vitality as I [write, type, work at my computer, paint, sculpt, play the piano].” Remember that you cannot use negative words. So you can’t say, “I am [writing, painting, etc.] without pain.” You could say, “My hands are free of pain,” but that still focuses your attention to some extent on the pain. Try to make the affirmations as positive as possible.
In addition to writing and reciting the affirmations, you can also visualize and feel them (affirmations will be presented in more depth in Chapter 17). In addition to seeing your own affirmations, another effective visualization for arthritis would be to picture the surface of your arthritic joint as if it were healed. To do so, you could imagine the most perfectly smooth, grayish-white, glistening cartilaginous surface of a chicken or turkey drumstick that you’ve ever seen. Every day you could take a few minutes to picture in your mind’s eye an irregular inflamed discolored cartilaginous surface being transformed into a perfectly healthy joint surface.
There is a published study that has documented the benefit of journaling about your feelings in treating arthritis (see Chapter 17).
Less common and often more disabling than osteoarthritis, rheumatoid arthritis affects between 2 and 3 percent of the American population. Women are affected three times more than men. Although it most commonly occurs between the ages of thirty and forty, the disease can begin at any age. In childhood it is called juvenile onset rheumatoid arthritis and afflicts seventy-one thousand children every year—six times as many girls as boys.
Rheumatoid arthritis is chronic and progressive and is thought to be an autoimmune disease. These conditions occur when the body fails to recognize its own tissues or cells and initiates an immunological response in which antibodies attack parts of the joint tissue, as well as skin and muscles.
The joint damage caused by RA begins with an inflammation of the synovial membrane. This then leads to thickening of the membrane resulting from the overgrowth of synovial cells and an accumulation of white blood cells. The release of enzymes and other substances by these cells can erode the cartilage that lines the joints, as well as eroding the bones, tendons, and ligaments within the joint capsule. As the disease progresses, the production of excess fibrous tissue limits joint motion.
Since RA is a systemic disease, symptoms can affect the entire body. Early in the course of the illness, even before the joints are involved, there can be fatigue and weakness, general feeling of malaise (feeling ill), low-grade fever, inflammation of the eyes, loss of appetite, and weight loss.
The disease can occur in many forms, from a mild short-term illness with little damage in only a few joints to a severe progressive condition with significant destruction of many joints. Most people are somewhere between these two extremes.
Joint symptoms include:
• Pain, swelling, and red/purple color of the finger joints (but not usually the joints closest to the fingertips), wrists, ankles, and toes—occurs symmetrically on both sides of the body (osteoarthritis does not present symmetrically)
• Warm and tender joints
• Stiffness, usually early morning, improves during the day
• Red, painless skin lumps called rheumatoid nodules, over the affected joints
• Bent and gnarled deformities (usually in fingers and hands) in long-term RA
There is no specific diagnostic test for RA, but from medical history, physical examination, joint X-rays, blood tests, and joint fluid analysis a definitive diagnosis can usually be made.
Like osteoarthritis, RA is an inflammatory condition. The MMJ recommendations are therefore much the same. However, the MMJ options are valued somewhat differently. For example, among the more than eighty cannabinoids, THCa is considered the most potent anti-inflammatory and is also effective in treating autoimmune conditions. THCa is not psychoactive and can therefore be used along with vaporizing a high-CBD hybrid, using a high-CBD tincture, or eating a high-CBD or hybrid edible. The topical creams, sprays, balms, and lotions can be highly effective for relieving pain without getting high. In conjunction with THCa, they are ideal during working hours. THCa is available by itself in both a tincture and a transdermal patch. But perhaps the best choice for RA patients is to juice raw leaves for a strong analgesic combination of CBDa and THCa.
• Juicing raw cannabis leaves
• THCa—available in both tincture or transdermal patch; tincture is more effective since it closely parallels the THCa in raw cannabis juice. Recommend using it along with a high CBD:THC product.
• Topicals—localized (apply to painful joints)
• Topicals—generalized (apply to wrist or ankle for rapid absorption)-transdermal patches, especially 3:2/CBDa:THCa; THCa; 1:1/CBD:THC; and transdermal gel pens
• Vaporizing high-CBD strains of flower—Harlequin (a 50:50/S:I hybrid), Lucy (a 70:30/I:S indica), Cannatonic (a 50:50 hybrid); or other hybrids (either 50:50 or 60:40/S:I or 60:40/I:S)
• High-CBD tinctures—1:1, 2:1, 3:1, 6:1, or 20:1/CBD:THC
• Ingesting high-CBD hash oil—3:1 or 6:1/CBD:THC
• Indica strains of flower, with I:S of 70:30 or above
• Indica and hybrid edibles—gluten-free, without sugar or dairy
• Any strain or MMJ product containing CBG
NOTE: Avoid sativa strains above 60:40/S:I and high-THC products. Although THC has anti-inflammatory properties, it can also increase anxiety, which very often will increase pain.
As with all chronic conditions, there are multiple factors that predispose to the development of RA. Although the exact cause is unknown, there is strong evidence of a genetic component and an immunological problem. Evidence for the latter places RA in the category of an autoimmune disease (the body reacting against itself). Some researchers believe RA is triggered by either a viral infection or a hormonal imbalance. There is some evidence that the disorder is related to a distorted permeability of the small intestine. Others have identified food allergies and psychosocial factors as possible prime contributors to this condition.
Although I am aware of some physicians who have observed significant improvement in patients using food elimination, there are very few well-documented cases of RA being successfully treated with holistic medicine. This may be a result of the advances made by conventional medicine in slowing the progression of the disease, coupled with the likelihood that many people with RA consult a holistic practitioner only during the latter, more disabling stages of their disease. The holistic treatment is most effective for milder cases of RA and is very similar to the approach used to treat osteoarthritis (see the preceding section), with the following exceptions and suggestions. Early intervention is essential, before there is significant joint destruction.
A vegan diet—vegetarian diet with all animal products, especially dairy and eggs, eliminated—is best. The exceptions to this diet are fish and high-DHA eggs (found in some health food stores). This diet can also serve as a food elimination diet to identify possible food allergens. The most highly allergenic foods associated with RA are dairy products, wheat/gluten grains, and corn. Some practitioners find food sensitivities significantly related to RA in up to 50 percent of cases. (See the “Osteoarthritis” section for the remainder of the dietary suggestions.)
A twenty-eight-day cleansing program utilizing the product UltraInflamX Plus 360 from Metagenics can be very useful to rapidly reduce inflammation for people with RA, especially in the early onset of the disease. This must be done under the supervision of a Functional Medicine practitioner.
The antioxidants, minerals, and supplements are essentially the same as for osteoarthritis, with the following prioritized items:
1. Glucosamine sulfate: not to the same extent as for osteoarthritis, but also considered moderately effective in treating RA; 500 mg three times daily.
2. Vitamin C: as ascorbate or Ester C; 1,000 mg three times daily
3. Essential fatty acids: especially EPA, an omega-3 (flaxseed oil is the most effective and economical means of taking it; daily dose is one to two tablespoons)
4. Omegagenics SPM Active: same dosage as osteoarthritis
5. Copper: 2 mg daily
6. Quercetin or curcumin (with bromelain): 250 mg between meals three times daily
7. Manganese: 30 mg daily
8. Selenium: 200 mcg daily
Digestive enzymes such as pancreatin have been helpful in treating RA, possibly by mitigating the effects of food allergies. The recommended dosage is 500 to 1000 mg with each meal. Probiotics, such as acidophilus- and bifidus-containing products, can help relieve the symptoms of RA by reducing bowel toxicity.
• Curcumin (turmeric): the best-documented herb for treating RA; a potent anti-inflammatory, usually supplemented with any of the following products. I recommend Curcuplex (Xymogen), a highly absorbable curcumin extract. Dosage: one capsule three times a day before meals.
• Bromelain: a pineapple extract and enzyme that also acts as an anti-inflammatory
• Bupleuri falcatum: a Chinese herb that seems to be as effective an anti-inflammatory as steroids and without the harmful side effects; 2 to 4 gm daily
• Siberian ginseng (eleuthrococcus): a Korean herb that strengthens the adrenal glands; 500 mg two times daily
• Hawthorn berries: a rich source of flavonoids that helps to heal joint membranes; one-half teaspoon or two capsules three to four times daily
The same therapies used for treating osteoarthritis can be used for RA. Some holistic practitioners have had success in treating RA with bee venom therapy.
Certain personality traits tend to be associated with RA. Those at risk tend to be more compulsive, perfectionistic, overconscientious and helpful, excessively moralistic, and more frequently depressed. Many people suffering with this disease are rigid and stubborn, inflexible and immobile. In a survey of eighty-eight children with juvenile RA, the most striking findings were the psychosocial factors: children whose parents were unmarried comprised 29 percent, while adoption occurred three times more often in this population. The onset of the disease, in 51 percent of the cases, occurred very close to the traumatic event—divorce, separation, death, or adoption. RA sufferers of any age may have been more vulnerable to any instance of separation, either real or imagined. Once again, we clearly see evidence supporting the core belief of holistic medicine: the perceived loss of love is our greatest health risk.
In addition to the recommendations made for osteoarthritis, psychotherapy can be quite helpful for people suffering with RA. There are usually painful deep-seated emotional issues related to RA that need to be addressed and released before significant healing can occur. Enhancement of family support and family counseling are strongly recommended with RA. Affirmations and visualizations can also be of great value with this condition.
Jessica R. is a thirty-five-year-old homemaker who homeschools her three young children. She was definitively diagnosed with RA in 2007, but she’d been having pain since age sixteen. Following her diagnosis, she was prescribed meloxicam, which she took briefly but stopped due to the severe abdominal pain it caused. Her only other medication was over-the-counter ibuprofen, which she took daily, often as much as 800 mg three times a day. It helped to somewhat relieve the severe pain she had in her hands, arms, shoulders, neck, knees, and ankles. But she was unable to exercise and her weight ballooned to 260 pounds.
She began taking MMJ in 2013 and experienced dramatic relief. After smoking a strong indica before bed, she was able to relieve her pain for nearly twenty-four hours. During the winter months her pain without MMJ was an 8, but it was reduced to a 2 with the indica or a 3:1/CBD:THC tincture; and during the summer months it dropped from a 5 to a 0 to a 1. She also uses the topical Apothecanna Extra Strength, which has helped tremendously with the pain in her hands. The MMJ has allowed her to sleep well, relieve her anxiety, and exercise on a regular basis, resulting in a weight loss of 120 pounds.
Nearly as common as RA is systemic lupus erythematosus (SLE), commonly known as lupus. SLE, like RA, is an autoimmune disease, a condition in which the body’s immune system mistakenly attacks healthy tissue. The disease can affect the skin, joints, kidneys, brain, and other organs, but almost everyone with SLE has joint pain and swelling—i.e., arthritis.
Although I did not present SLE in this chapter, it is not an uncommon form of arthritis and this patient had a dramatic improvement with MMJ.
Twila Z. is a fifty-nine-year-old retired teacher who was diagnosed with lupus in 2007 shortly after developing symptoms of red patches and rashes on her chest and face area, fatigue, and swelling in her joints. She immediately began a course of steroids and Cytoxan (a chemotherapy drug). The side effects of the drugs were devastating. She became dizzy, fainted, and was taken by ambulance to the hospital with very erratic vital signs and a leg that had broken in three places.
The Cytoxan was stopped, and although that helped lessen the dizziness, she had two more falls in the next four years that caused repeat fractures in the same spots. The fractures were the result of weakened bones from the ongoing steroids. She was in a cast for three months, and was using assistive devices to get around, such as a walker, cane, and at times, a wheelchair.
She had to severely curtail her physical activity, due to the pain, swelling, and the fear of breaking a bone again. In 2012 she had to retire from teaching as a result of her physical limitations. “My weight ballooned and I was becoming a shut-in.”
On the advice of her son, she applied for a medical marijuana license as an alternative to the drugs she was taking. The relief she obtained from CBDa patches and smoking cannabis was immediate, and through trial and error she has found what products work best for her. Her condition improved enough after a year of using cannabis products that she was able to have an ankle replacement done on a joint that had been broken three times in six years.
She still had to use assistive walking devices until 2016, to allow for complete healing of the surgery, but the pain was manageable, and gone completely for weeks at a time. Through the use of MMJ, she was able to endure a year of physical therapy, and is now able to walk one to three miles a day without any problems, and to work out thirty minutes daily on weight training.
“While cannabis cannot cure my lupus and cannot stop bad days where I am immobile, I have been able to stop the use of chemotherapy drugs and to cut back on my steroid use. The joy I feel doing basic things, like going to the grocery store without having to use a motorized cart, is immeasurable. I know that when the pain starts, a quarter of a CBDa patch will take away the pain in a half hour, and the patch won’t weaken my bones, making them brittle. I may not be able to ice skate, ski, or do competitive swimming ever again, but I can travel and enjoy my day-to-day life; no tethers to having IV treatments getting in a plane or car.
“Medical cannabis has definitely made a huge difference in the quality of my life, and I am looking forward to the day when such treatment options are available worldwide, and not looked at with suspicion and fear. I am fifty-nine years old, and definitely not a “stoner.” The myth of cannabis only being used for getting high is an antiquated fallacy; the more informed the population is about the successes of cannabis in the treatment of chronic pain and disease, the sooner that myth can be dispelled.”